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Addressing the opiate crises, today and tomorrow

By: Sam Keaser

Sam Keaser was born in raised in the small town of Heath, Ohio. The effects of drug addiction on his community pushed him to co-found Crosswave Health, a technology startup addressing the opiate crisis through software solutions. 

The opiate epidemic doesn’t discriminate. Or, more accurately, it discriminates less and in different ways than past drug crises have. Where previous crises were associated largely with black, urban, and poor populations, the present epidemic crosses racial boundaries, has its roots in the rural Midwest and South, and is not limited to one class. While other drugs found “popularity” in cultural, racial, and geographic niches—think cocaine among jazz performers in New York or marijuana use in young white American urban and suburban subcultures—the opiate epidemic has roots in the over-prescribing of pain-killers in Southeastern Ohio, Northern Kentucky, and Florida. The present crisis, though, is not wholly unique. Drug use in America is, after all, not new, and changing demographic patterns do not fundamentally change the equation. Addressing opiate use means both addressing the conditions under which drug use flourishes and creating long lasting institutions concerned with curbing both the supply of and demand for the drug.

High opiate addiction and overdose rates among young Americans—and especially young white Americans, whose overdose rate increased five-fold between 1999 and 2014—mean that the epidemic will not be eliminated easily. In 2016, around 60,000 Americans died from drug overdose, a 19% increase from 2015. Both numbers are expected to grow in 2017. More broadly, death rates for Americans aged 25 to 34 have increased across the board. Drug and alcohol use are largely to blame. Bracket for a moment, though, the rising numbers of overdose deaths annually and consider the long-term impacts of more children in social services, more working-age men and women in prison, and declining economic prospects for American millennials. Not only does the current epidemic—which already costs Americans over $75 billion for treatment and social costs—need to be curbed, addressing its lingering effects will require additional resources and community action. Social fatigue is likely and is already seen in some of the hardest hit communities, but continued engagement is vital to address both the crisis itself and its broader social ramifications.

We must address both the opiate epidemic and its underlying causes. The only way to break the cycle between at-risk populations and opiate addiction is to address both at once. That is, only attempting to curb the supply of opiates without addressing the underlying social demands is unlikely to produce fewer addicts in the long run. The failure of America’s decades long “War on Drugs,” itself a supply-focused replacement for the more demand-concerned “War on Poverty,” is instructive. By only targeting the supply of opiates and criminalizing opiate users, we risk failing to curb the epidemic itself. Without the creation of a more robust, diversified economy, self-sustaining communities across the urban-rural spectrum, and smarter approaches to drug rehabilitation, it is unlikely that the opiate epidemic will be effectively addressed.

Significantly, though, the opiate crisis presents the U.S. and individual states with the opportunity to reevaluate our priorities and restructure our institutions. Changes in policing and emergency services can already be seen in several communities. Through initiatives driven by police officers, firemen, EMS, and social workers across the country, first responders are looking at models to curb crime before it occurs. In contrast to previous epidemics, they are leveraging the tools and skills they possess to begin reducing the demand for opiates, if only in small ways.

Several communities across the country are instructive on this point. Police, fire, and EMS departments adopted the Colerain Township Quick Response Team (QRT) model. Colerain, a community north of Cincinnati, Ohio created a task force of social workers, police officers, and EMS personnel to follow up with individuals who overdose. Once contacted, opiate users are assisted in seeking treatment options and throughout their recovery. Other police departments have adopted the Police Assisted Addiction and Recovery Initiative (PAARI) pioneered by police in Gloucester, Massachusetts. Individuals can forfeit drugs and drug paraphernalia to PAARI affiliated departments without risking arrest for possession and receive support moving into treatment. In both cases,  first responders and social workers act as liaisons between people experiencing addiction and local support services. Neither initiative alone will solve the problem entirely, but both are examples of the hard yet sustainable work being done around the crisis.

Unless we do something, the opiate epidemic is here to stay. Significant political, civil, and private movements are underway to curb the crisis, and will likely be successful on some level. That said, the long-term ramifications of overdose deaths and addiction mean that our social and political responses to the crisis must be designed with the future in mind. We see, fortunately, movements towards this at the local and state levels. The creation of QRTs, among other things, indicates the willingness of Americans to engage in forward thinking and actions around the opiate crisis. Change is necessary, and change is possible.

//sk

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